Iatrogenic Cushing's Syndrome Due to Overuse of Topical Steroid in the Diaper Area

Cushing’s syndrome is the result of abnormally high blood levels of cortisol or other glucocorticoids. Iatrogenic Cushing’s syndome is caused by exogenous glucocorticoids; adrenocorticotropic hormone is an independent type of Cushing’s syndrome [1]. Iatrogenic Cushing’s syndrome often occurs due to prolonged use of oral or parenteral corticosteroids [2]. Prolonged use of topical corticosteroids may cause Cushing’s syndrome, and suppression of the hypothalamopituitary–adrenal axis is less common than with use of oral or parenteral types [3–8]. In this case of a 7-month-old male infant who developed Cushing syndrome due to topical steroid application, we emphasized that topical corticosteroids should be carefully used, especially in infants. The 7-month-old male patient was admitted with coughs and complaint of fever. His history showed that the family had consulted a physician for a rash on the genital area when the patient was 3 months old. Ointment containing 50 g clobetasol 17-propionate had been prescribed for diaper dermatitis. The mother had applied the ointment to the genital area three to four times a day for 4 months, and she had used four boxes. Swelling over the face and all over the body appeared after 2 months of applying the ointment. The patient was admitted to the hospital when the family detected these side effects. The pediatrician said it was in the process of development of the baby.